Background Young adults in Australia face barriers to accessing sexual health services including concerns over confidentiality and privacy, cost, lack of transportation and limited options around medical providers. A possible solution to decreasing these barriers is the use of telemedicine.
Method An online questionnaire examined young adults' (aged 16–24) views on using webcam and telephone consultations for sexual health in Australia. Descriptive statistics were used to describe the study sample and χ2 was used to assess associations. Free text responses were analysed thematically.
Results 662 people completed the questionnaire. Overall, 23% (n=150) of participants were willing to have a sexual health consultation with a doctor using a webcam if no genital examination was necessary; this number decreased to 16% (n=105) if a genital examination over webcam was needed. Men were more willing than women to have a webcam consultation (28% vs 21%, p=<0.01). In addition, men with same sex partners were more willing to have webcam consultation, with an unknown doctor, than men without any same sex partners (48% vs 26%, p=0.04). Participants' top preference for consulting a doctor if asymptomatic and living 2 h from a doctor was telephone (51%, n=340, compared with 10% for webcam); if symptomatic, participants' top preference was in person (62%, n=412, compared with 16% for webcam) instead of having the consultation over a webcam. While it was hypothesised that webcam consultations would decrease privacy and confidentiality concerns by preventing people from having to present at a sexual health clinic, preliminary results suggest that webcam consultations may instead augment such concerns. Free text responses suggest that this may be due to the fact that online consultations can be recorded, stored and potentially, if security measures are breached, be retrievable and searchable online.
Conclusion To our knowledge, no study has examined the use of webcam consultations between healthcare providers and clients for sexually transmitted disease care. Results suggest that webcam consultations are not yet an acceptable medium for sexual health consultations for youth in Australia. Concerns about trust, privacy and security around online medical consultations are likely to influence whether such technology is eventually adopted into routine medical care.
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